NCG120005_MONITORING INFO_20200116

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
C G% c2D 0 O 5
DOC TYPE
❑ HISTORICAL FILE
E) MONITORING REPORTS
DOC DATE
❑ �"`� D b I
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and �Land Resources General Permit No. NCG120000
Date submitted / - /coo
CERTIFICATE OF COVERAGE r9o. NCG12
FACILITY NAME <
COUNTY Rob(,-Sor)
PERSON COLLECTING SAMPLES Kn t1Ao. kV('yl&r
LABORATORY �� iLab Cert. If
Comments on sample collection or analysis:,
5 SAMPLE COLLECTION YEAR 40 M
SAMPLE PERIOD ❑ Jan -June ® July -Dec
or ❑ Monthly'(month)
S DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
Z8Z¢ ❑Zero -flow ❑Water Supply ❑SA
u . - _- -f -f- RECEIVED ❑Other
Detc>leh 9S YIEblLrgl t3y iGerm!
Part A: StormwaUter Benchmarks and Monitoring Results
JAN 16 2020 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
DWR SECTION! 7No discharge this period'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Chemical Oxygen
Demand
mg/L
Fecal per Col1 0
Colonies per 100 mL
Total Suspended
Solids
mg/L
and
Standard Units
Benchmarks
_
-
120
1000
100 or 504
6.0-9.0
Parameter Code
-
46529
00340
31616
C0530
00400
C'r"+
JAN I
FILES
Monthly sampling (instead of semi-annual) must begin with the second consecutive'tien`eRh &kxceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
"See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier I, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018
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Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this periodz
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches3
Non -Polar Oil & Grease
mg/L
Total Suspended Solids,
mg/L
New Motor or Hydraulic Oil Usage,
gal/mon
Benchmarks
-
-
15
100 or SW
Parameter Code
-
46529
00552
C0530
NCOIL
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. see General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal coov of this DMR. including all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitorinq period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
amfpware th?t(here are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee
Permit Date: 11/1/2018-5/31/2021
% `l-020
Date
SWU-248, last revised 11/1/2018
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